Discussing Eye Health with Dr Gladys Atto, the first and only ophthalmologist in Uganda's Karamoja Subregion
"I am passionate about leaving no one behind when it comes to eye health, and last year I completed further study in public health to help me step up my advocacy for eye health." - Dr Gladys Atto
Dr Gladys Atto is the first and only ophthalmologist in the Karamoja subregion in Uganda. She is also one of only 45 ophthalmologists in the entire country. She works at Moroto Hospital in Uganda, which serves a population of about 1.2 million people and helps perform about 18 operations a week.
In this interview, she tells Document Women about her passionate for eye health and how her community and work is geared towards the well-being and eye health of the general public.
“I have a bachelor’s degree in medicine and completed a master’s in ophthalmology, sponsored by the international organisation Sightsavers in 2018 at the age of 29. Now, in my early 30s, I am a Regional Ophthalmologist and Head of the Department of Ophthalmology at Moroto Regional Referral Hospital. I am passionate about leaving no one behind when it comes to eye health, and last year I completed further study in public health to help me step up my advocacy for eye health.”
“My role involves supervising and training colleagues, screening and treating patients and performing surgery for cataracts and other eye conditions. I also participate in outreach camps, visiting rural areas to reach people who can’t easily get to our clinical base. I hope my impact goes far beyond these activities though. My mission is to make systemic changes to the eye health system in Uganda.”
In 2021, Gladys Atto received the Uganda Medical Association’s prestigious Prof. Josephine Nambooze Women in Medicine Award, named after the first female doctor in East Africa. The award was given in recognition of her eye health expertise and contributions to Uganda’s health system.
She tells DW that she was “also nominated for the ‘Doctor of the Year’ and ‘Global health champion – North’ categories of the Ministry of Health’s Heroes in Health Awards in 2022 and listed in the top 22 for the Association of Surgeons of Uganda’s Women in Surgery Rising Stars 2023.”
To Gladys, the recognition of her work pushes her "to work even harder and makes me feel like my work on the outskirts of Uganda is being recognised. Public health is so important, and prevention goes a long way.”
What inspired you to venture into medicine and ophthalmology specifically?
For as long as I can remember I always wanted to be a doctor, and then when I was doing my undergraduate study I became interested in eye care. My interest was rekindled during an internship when I realised the hospital where I was practising only had one ophthalmologist. I realised there was a dire need for additional human resources in eye care.
The eye fascinates me, it is small, but its functions are so interesting. I am a detailed person and that lends well when it comes to eye surgery, you need to have that focus and skill. I am proud to be an ophthalmologist and have an impact on people’s lives.
What do you enjoy most about your work?
The best part of my job is knowing I have helped restore or save sight. In particular, I get excited when my patients are explaining what they can see to me when the bandages are removed after eye surgery. I see people smiling, they can see the colour of the clothes I’m wearing, my shoes, their own fingernails. I love seeing the impact, it is so rewarding. I also love sharing information about eye health with the general population. I dream that one day, everyone will be empowered with knowledge about eye health.
What challenges do you encounter most in your line of work?
In eye health, there are many challenges to contend with. In Uganda alone, the number of people in need of eye care is spiralling. There were an estimated 3.1 million people with vision loss in 2020.
This is a global problem, not just a regional one, and it is estimated that without concerted action, 61 million people could be blind by 2050 due to global population growth and ageing. Eye health is often forgotten about and underfunded. But eye health equals opportunity, allowing children to learn and adults to earn.
Good eye health has a ripple effect on society and can help individuals, families, communities, and nations, to thrive. In Karamoja, health-seeking behaviour is poor and people aren’t always aware of the services available. For example, they may think cataracts only affect older people and can’t be treated. There are also often barriers to health access, particularly for women and people with disabilities.
Due to cultural influences, women may not be able to access healthcare without permission or financial support from a male relative. For people with disabilities, they may rely on others to help them access health services, their health may not be prioritised, or health facilities may be inaccessible. Karamoja also has low resources in terms of eye health professionals. I am the only ophthalmologist, for a population of around 1.2 million people.
When I go on leave or if I am unwell, service delivery is cut. I do as much as I can, but it is tough. Working with Sightsavers, the government and other partners, great strides have been made in raising awareness of the importance of eye health, creating inclusive access to health services, and reducing discrimination towards people with disabilities, women, and other marginalised groups.
Hope is not lost, but we need to increase the attention eye care is given and recognise how integral it is to every facet of life. If we are to tackle the eye health burden, continued collaboration, resources, funding, and commitments are needed from the government and other organisations to integrate inclusive eye health into wider health, education, employment, and development systems.
Raising awareness of the barriers for women and people with disabilities and the importance of good eye health will also help. We need to empower women and people with disabilities with knowledge about their rights so that they can be part of the decision-making that affects them. Being a woman in a medical role also brings its challenges.
For example, I have had patients ask for second opinions from male colleagues because there is a misconception that women are nurses and men are doctors. There can be a tendency to overlook females in leadership roles, which can make it challenging to deal with people who can’t imagine how I, as a young woman, can come in and tell them what to do.
Why did you decide to practice in Karamoja and how has your experience practising there been so far?
I realised how few ophthalmologists there were in Uganda overall and that most of them were in urban areas. It frustrated me that people needed eyecare in rural areas but they couldn’t easily access an ophthalmologist. I chose to work in Karamoja because there wasn’t easy access to eye health here. Before I came here, Karamoja had never had an ophthalmologist. I was a little unsure at first as I knew it was a remote area, but I quickly fell in love with the place.
Please tell us about your work with Sightsavers
Sightsavers is an international organisation that works across Africa and Asia to end avoidable blindness, treat and eliminate neglected tropical diseases, and promote equality of opportunity for people with disabilities. Its vision, of a world where no one is blind from avoidable causes and people with disabilities participate equally in society, sits well with my vision and aims.
I first connected with Sightsavers when they were seeking scholarship applications for eye health studies. I was successful in my application and Sightsavers supported me through my master’s degree. Since then, the organisation has provided our hospital with equipment to diagnose and treat people with eye health issues. It also supported the construction of a dedicated eye health unit.
I continue to partner with Sightsavers to treat and prevent avoidable blindness, including the inclusive eye health project which is funded by the UK government through UK Aid Match. The project has so far helped over 32,000 people access basic eye health, and aims to restore, save, and protect sight across rural and high-poverty areas in Karamoja.
In collaboration with the government and other organisations, we focus on cataracts and reaching people who face barriers to accessing health care, including people with disabilities, nomadic pastoralists, and women and girls.
This work includes many initiatives, including eye examinations, cataract surgeries, disability and gender inclusion training for health professionals, community-based screenings, national scholarships for trainee eye surgeons, and health facility accessibility audits. Sightsavers is also contributing to an inclusive national eye health plan and advocating for the integration of eye health services into national health systems.
Dr Gladys Atto's work with Sightsavers has helped improve the lives of many and their dedication to promoting eye health is noble and admirable. However, there is a clear need for the development of ophthalmology in Uganda and around the world, so that eye care is more readily available and accessible to the general public.